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Client:
  
Date:
Month: Day: Year:
Start Date:
Month: Day: Year:
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Start Time:
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Locates:
Job #
Field Staff:

Cell #

Hotel:
Jobsite:
Stratigraphy:
Y or N
Flagging:
Hydrovac:
Permits in place
BC 1 Call 48hrs prior
# Of Wells
# Of Boreholes
Est Depth:
Drill Method
Standard Required Y/N
Solid Stem Augers: 50FT Access Issues
Hollow Stem Augers: 50FT
Odex 90mm Casing: 100FT Low Clearance
Drill Rods: 100FT
Slip Caps: 25 Track Rig
J-plugs: 25
Solid 2" Well Casing: 300FT Notes:
Slotted 2" Well Casing: 200FT
Flush Casing Protectors: 15
Stand Up Casing Protectors: 8
Premix Concrete: 15
Silica Sand: 50
Bentonite Chips: 40
Bentonite Grout: 10
Level 1 First Aid: 1 1
Eye Wash Station: 1 1
First Aid Blankets: 1 1
Survey Gear: 1 1
 
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